Michigan State University in conjunction with the Michigan Department of Community Health and the Michigan Department of Labor and Economic Growth has been conducting state-based occupational safety and health surveillance since 1988. This proposal will continue and expand this activity. This proposal will fund activity to generate the occupational indicators and surveillance programs for four specific conditions: (1) work-related asthma; (2) work-related noise induced hearing loss (NIHL); (3) silicosis; and (4) acute pesticide illness. The state has had SENSOR funded projects in work-related asthma since 1988 to date, silicosis from 1988-1992 and 2002 to date and work-related NIHL from 1992 to date. With this funding, occupational disease reporting has increased from less than 100 reports a year prior to 1988 to 15,000 - 20,000 reports a year. The state has continued silicosis surveillance without SENSOR funds from 1993 to 2001 and work-related NIHL from 2000 to 2002. The State initiated acute pesticide illness surveillance in 2001. Since initiation of surveillance 2,074 cases of work-related asthma, 924 cases of silicosis, 23,771 cases of work-related NIHL and 183 cases of acute pesticide poisoning have been confirmed. Seven hundred and eighty-five follow back industrial hygiene inspections have been conducted, and 8,443 fellow workers interviewed during these inspections. The confirmation process, industrial hygiene inspections and fellow worker interviews will be continued. There has been 100% reporting from the 156 acute care hospitals in the state. Two quarterly newsletters (total 85 different newsletters) and 4 annual reports per year (total 59 different reports) have been written and mailed out to approximately 4,000 targeted physicians and health care professionals. Active outreach to encourage reporting will be continued. Additional activity that will continue will include presentations and display booths at medical meetings, publishing papers in the medical literature and working with other state organizations such as the medical licensing board to publicize Michigan's occupational disease reporting law. Evaluation of the effectiveness of our effort to improve working conditions will also continue. In addition, to the above basic surveillance we will be expanding our outreach, follow back and evaluation activity. New activity planned includes: expanding our use of workers' compensation data, conducting [unreadable] follow back interviews of previously confirmed asthma cases and fellow workers, projects on under reporting, evaluation of OSHA inspections for following up reported cases, projects on special populations, implementing new reporting requirements for cholinesterase, arsenic, cadmium and mercury, and a strategic plan for hearing loss. [unreadable] [unreadable]